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相關文獻
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題名 | Single-portal Endosopic Carpal Tunnel Ligament Release=腕隧道症候群單一切口內視鏡手術法 |
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作者 | 施世亮; 施天岳; 楊瑞成; 楊長彬; | 書刊名 | 北市醫學雜誌 |
卷期 | 1:1 2004.01[民93.01] |
頁次 | 頁81-87 |
分類號 | 416.26 |
關鍵詞 | 腕隧道症候群; 內視鏡單一切口; 正中神經減壓; Endoscopy; Portal; Carpal tunnel syndrome; |
語文 | 英文(English) |
中文摘要 | 背景:腕隧道症候群是十分常見的週邊神經問題。目前的手術方式仍然以傳統的開放式腕隧道減壓術為主,其缺點是在手術後常見握力減弱及手掌魚際疼痛。相對地,內視鏡壓手術有許多好處,但方法種類繁多,且神經血管較易受傷,如何能簡單又安全地使用內視鏡手術來處理腕隧道症候群是我們完成這篇報告的動機。方法:我們使用Dr. Agee所提出,經改良過的單一切口的內視鏡減壓術,治療兩位罹患腕隧道症候群之女性病患。在術前我們先以超音波為手掌的重要血管定位,並使刀口遠離正中神經,尺神經及其分支,以避免神經血管的傷害,而且能在內視鏡下使腕橫韌帶完全切開。結果:兩位病人的疼痛感在手術後立刻解除,麻刺感在兩週內消失,三週內可回到工作崗位,病人滿意度高,且無任何神經血管受傷的併發症。結論:以內視鏡手術治療腕隧道症候群顯然利多於弊,我們相信在慎選病人,術前儘可能為重要神經血管定位,並選擇適當的入口,將可降低不必要的手術併發症。 |
英文摘要 | Background: Carpal Tunnel syndrome is one of the most common peripheral neuropathies. Open carpal tunnel release has been the gold standard for surgical treatment of carpal tunnel syndrome for decades. However, side effects of this procedure include pillar pain, hand weakness, scar tenderness, delay in returning to work, and slower recovery of function. Endoscopic carpal tunnel release procedure can reduce these side effects, but is associated with a higher rate of nerve and artery injuries. Case Reports: We report idiopathic carpal tunnel syndrome in two women treated with single portal Agee technique. A small incision was created just ulnar to the palmaris longus tendon and what instrument was introduced under the transverse carpal ligament and directed toward the axis of the ring finger. The superficial palmar arch was located by ultrasound examination before the pneumatic tourniquet cuff was inflated. Pain had resolved immediately after the operation and residual numbness disappeared within two weeks. Neither patient had any complications affecting nerve or arterial structures. Both patients returned to work within three weeks and regained their pre-operative grip and pinch strength within three months. Conclusion: With careful selection of patients, thorough location of vascular structures by noninvasive methods and proper entry incision, single portal Agee technique is a safe and simple surgical procedure for the treatment of carpal tunnel syndrome. |
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